Say Thank You (with Dr. Bob Wachter) | Crooked Media
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February 23, 2021
Pod Save The People
Say Thank You (with Dr. Bob Wachter)

In This Episode

DeRay, Kaya, and Sam dive into the underreported news of the week, including child exploitation during a pandemic, linked fate, and jury exclusion. Netta Elzie gives an update on what’s happening with the nationwide protests. DeRay sits down with Dr. Bob Wachter, guest host of “In the Bubble” podcast on Lemonada Media, to discuss the vaccine roll-out and the dangers of upcoming coronavirus spikes.




In the Bubble podcast



DeRay Hey, this is DeRay.  And welcome to Pod Save the People.  In this episode it’s me, Sam, Kaya and De’Ara, and we talk about the news that you don’t know and then Netta comes to tell us what’s happening with the protests across the country. And then I sit down with Dr. Bob Wachter from the podcast In the Bubble to discuss the vaccine rollout and the danger of spikes around the mutated strains we’ll be facing next. I learned a lot in this conversation. Some things I really just straight up didn’t know. My only advice is say thank you, ya’ll. Say thank you. When people do nice things and people show up for you and people can say thank you, don’t assume people get it. Don’t think that they might understand. Just say thank you.

DeRay Here we go.  Hey Everybody it’s another week of the news that you don’t know. This is DeRay @deray on Twitter.

Sam This is Sam SInyangwe @samswey on Twitter.

Kaya I’m Kaya Henderson @hendersonkaya on Twitter.

DeRay So this past week, the news that we can’t stop talking about is Ted Cruz thinking that he was going to fool us all by going to Cancun in the middle of the worst snowstorm in his lifetime, for sure, in Texas. And my favorite part of the whole story is not only like he got caught in the airport and he came home the next day saying that like he was going to come home anyway, but that the group that leaked the text of his wife, that’s like the best part of the story. His wife’s friends were like Nah, these jammers lying, look at the text. And it was like, see, your friends don’t even like you.

Sam It was one of these like case studies in what happens when, like, literally nobody likes you because it wasn’t just the group chat leak. It was like the police leaked that they were called in to escort him to the airport. You had the like we knew things about the plane ticket when he bought the ticket and that he originally planned to stay until Saturday. So sounds like the airlines were leaking some information. So it was like everybody, you know, you had the people at the airport taking pictures and following him around. So it really was like a team effort. Everybody came together to to track Ted Cruz and to make sure that the public knew that he was trying to leave the state in the middle of a crisis.

Sam And then he blamed his kids. We didn’t even talk about him blaming his kids.

Kaya See, that’s what’s pitiful about it. He blamed his daughter’s dang like I mean, just own it, right? You did it. You invited you. Look, first of all, the wife was like, hey, all y’all want to go to the Ritz Carlton? Come on. Come on. Who can, who wants to? And nobody apparently took them up on that. Right. And then you blame your kids. My kids really wanted a vacation. Just own it. Right. You got caught. Just own it. But he lied 55 different ways before he finally was like, OK, yeah, this was a bad decision. Are you kidding me?

DeRay It was really something. And and meanwhile, AOC, who represents the Bronx, New York, is doing fundraisers. She’s like, these are all our people.

Kaya She got four million dollars she raised.

DeRay She is organizing. And it’s like this what you should have been doing, but use up playing games in Cancún. And it was also great to see that suitcase, massive suitcase. He’s like, I was just coming for a day.

Kaya And you’re like with the with the extension, you know, when you have to pop out, you got so much that you carry on, you got to pop it out. Oh my gosh.

Kaya and people were like, no, thank you.

Sam What’s going on with the haircut? Also the mullet.

Sam If we can talk about the mullet.

Kaya On Saturday Night Live, they gave him cornrows, which was hilarious. Cornrows with beads, which many tourists come in from Cancun has returned with. It was so funny. The big question is whether or not they’re going to hold him accountable at the polls. Right. That’s what really matters.

DeRay I mean, that is it’s like and, you know, this is one of the things that people of all party people across socioeconomic class have been impacted by the sheer lack of leadership in Texas. I mean, just overwhelming. You know, some people have been like, well, what was Ted doesn’t control the he doesn’t control the power grid. It’s like, yeah, but this is the one moment where, like, he should be doing some kind of direct service. He should be wrangling every resource of the federal government, every connection he knows like this. This is the time where you do it.

DeRay And instead, he is trying to get out of Texas talking about it’s freezing, your’e like no shuts.

Kaya Vacationing while other people are standing in lines in your state to get food and water. Vacationing at the Ritz Carlton in Cancun,.

DeRay One of my friends was like, what airport is even open?

DeRay They were like, I’m in Texas and I don’t even know where you fly out right now because, like, everything’s so bad.

Kaya Oh, Ted Cruz,.

DeRay Kaya take us away?

Kaya My news this week is super exciting is from Psychology Today, an article by Dr. Marisa Franco called The Science of Why Black People Root for Everybody Black. I’m super excited about this. You know, when you finally get some science to back up what you already knew forever and ever. So from the time I was a little girl, we’ve been rooting for everybody black on TV. And in 2017 at the Emmy Awards, Issa Rae  laid it all out and said it for. The world to hear they asked who she was rooting for to win Emmys, and she said, I’m rooting for everybody black. Well, then it became a T-shirt and a thing and whatnot. But most black people that I know have always been rooting for everybody black. And it turns out there is some science behind it. It’s actually the psychology of how black people relate to one another. There’s a concept called Linked Fate, which was posited by a political scientist named Michael Dawson, which effectively says that black people feel that their destinies are tied to the destinies of other black people. Go figure. Of course. And so what it means is that, in fact, a quote from the article “linked Fate means that when one person succeeds, other black people feel their success vicariously.

Kaya One person’s success is the entire communities. This leads to a communal rather than competitive dynamic among black people.  Wherein black people are willing to help one another.” And so there’s another report by the Pew Research Center which found that black people have a higher rate of linked fate than any other racial group in the country. Now, this is not surprising to most black people, but it is always helpful to have the science back up what we know inherently or what we know communally. Many people remember the concept of Ubuntu, which was made popular by Reverend Desmond Tutu, but is a South African concept which says, I am because we are. It talks about common humanity. What happens to one person affecting everybody but who Ubuntu is about all humanity being interconnected. Linked fate is really specific around people of African descent. And the article wonders, is it racist? Is it unfair? And the truth of the matter is, because of the environment that racial discrimination creates for black people is more difficult for black people to succeed. And so black people counteract this unfairness by supporting one another. It’s our attempt to level the playing field. The inverse is also true, right? When one black person wins, everybody wins. Well, when something bad happens to one black person, the pain is felt by the entire black community. Why? Because if it happened to that person, it could happen to me. So there’s interesting research around police shootings of unarmed black people. In fact, the article states that there’s poor mental health among black people living in the state where the police shooting occurred. There was also a report that was released last summer called The Effects of Police Violence on Inner City Students. And that report found that when there was a police shooting, especially of an unarmed person, you saw significant increases in student absenteeism. You saw decreases in grade point average 9th graders were actually less likely to graduate from high school and go on to college if they lived in the vicinity of a police shooting and that those effects were particularly pronounced among black and Hispanic folks. So ultimately, it reinforces this idea that black people experience a collectivism in our emotional world, not just in our physical world. And I thought this was a pretty interesting article.

Sam You know, Kaya, this is a fascinating read. And it sort of took me back to when I was studying political science at Stanford back in 2009, 2010. This was right after Obama had been elected. And I remember in, like the political science discourse, there was a lot of attention being paid to this idea that, you know, were we in a post-racial society, obviously like we’re not right.

Sam But a whole lot of predominately white professors were positing that, you know, the election of Obama signified a game change in terms of discrimination and racism and that those things were going to be a thing of the past and we were going to move into a place. And that sort of that conversation interacted with this linked fate conversation because, as you said, Kaya a big piece of this, of what we think of in terms of linked fate is the collective experience of discrimination that black people face all across this country and indeed across the world, and that that shared experience of discrimination and adversity has sort of brought us together in order to to fight back in order to survive. Right. And so this idea that if there is less discrimination, how does that impact how we see ourselves, how we see ourselves as a community? Are is linked fate going to continue to be strong in that environment? I think that, you know, all of that was way premature because as we’ve seen, you know, racism has not gone away. Obama was followed by Trump and, you know, everything got even worse. But it is something to think about, you know, how we’re able not only to, like, talk about these things and understand them in our own lives, but now, like in political science, they are measuring these things. Right? There are surveys that ask. Well, how closely do they do they feel connected to the broader black community? How closely do they feel like if something happens to another black person, that it affects them? And I think that that these things are actually central to sort of the race and politics conversation, how we actually understand the political behavior of black people right in this country, how we understand voting behavior, how we understand, you know, how folks are coming together to support one another in crises. So, again, it’s really critical and it is something that we’re learning more and more about. You know, to your point, Kaya around police shootings. You know, that study that you referenced, I believe it came out of Boston University looking at the mental health impacts of police shootings, particularly of unarmed black people. That study used our mapping police violence database. They were able to find these what they call collateral consequences of police violence, where, you know, now we’re able to track scientifically where police violence occurs. It doesn’t just impact the individual who was harmed by the police. It impacts families. It impacts entire communities. Indeed, what that study suggested was it impacts black people as a population in a given state whenever an unarmed black person is killed by the police. So, again, these are things that that are fascinating. They impact our lives and how we see ourselves. And they are constantly changing and evolving over time. And the science is just catching up to that.

DeRay It is always interesting when you find the academy giving language to things we knew. Right. You know, we’ve always had to have an understanding of community that was outside of the way people traditionally thought of it. We couldn’t have an understanding of community that was rooted in legal relationships because we were not allowed to have them. We couldn’t have an understanding of community that was rooted in proximity because our proximity was always disrupted by the violence of the state.

DeRay You know, we had a sense of community that wasn’t even just on labels like cousin, brother, like neighbor. It was always bigger than that because we knew that if you do it in Texas or Alabama or Mississippi or Tennessee or whatever you might do it here too.  That Like that’s what’s one of the ways white supremacy bears down on black people is that one opening will lead to a host of things. So it was interesting to see the data to just like reflect that. You know, I was like, wow, look at that. Like that is actually like a go ahead linked fate as a way to, like, talk about the power of community, which we knew. It was cool to see to that. Like, this is something that is not just like a cool thing we talk about in our silo that we believe is true in our corner of the world. But it actually is sort of just a true thing, as an organizer. It makes me think about how we use this as a tool and how it is important that we, like, remember to build a coalition among us because people already like we don’t have to convince people of linked fate. They already believe it. So how can we actually just, like, bring more and more people into the fold as we start to think about solutions and the end of mass incarceration and the president and all those things have me think of. But it was cool to just see the language in the academy.

Kaya What was also sort of interesting to me is this idea that like black people experience a collective world, right? Physically, emotionally, what have you. And, you know, King talks about the inescapable network of mutuality that we are all caught up in. But America actually teaches us about rugged individualism. Right. In fact, the underpinnings of this country are about competition as opposed to collectivism are about individualism as opposed to collectivism. And so in some respects, I think that collectivism and this community is our superpower. It’s the thing that has allowed black people to persist through our 400 year history here against all odds. And so I thought that it was super exciting that the science was backing up that like this thing that has held us individually up and and collectively together throughout the onslaught of American history, that, in fact, science has now legitimatized it in a new way.

Kaya And we can take it from, you know, the red carpet with Issa Rae to the academy.

DeRay So the linked fate actually like means something culturally to and I think is a it’s a testament to black culture being the cultural driver for what it’s cool. It’s like there’s like a common thread throughout all of it, which I which I just love. So shout out to set out to black people.

Sam Now, Sam with a depressing news, everyone.

Sam With the depressing news of the day.

Sam So my news is a new report from the Prison Policy Institute, which looks at the exclusion of people from juries based on criminal records. So this is something, you know, we’ve touched on in the past. We’ve certainly talked about felony disenfranchisement in the context of voting. But what this study looks at is the practice of prohibiting people from serving on juries if you have a felony conviction. And in some states, I didn’t even know that you can be prohibited from serving on a jury for a misdemeanor conviction and even a misdemeanor charge, even if it has yet to lead to a conviction, can prohibit you from serving on a jury in many states, including places like Florida and Texas. So, again, big picture. What this analysis did was look at the state level. And what they showed was that there was a lot of variation in terms of the extent to which people are being barred from serving on juries based on criminal records. So in places like Colorado or Illinois, if you are currently incarcerated, you’re not allowed to serve on a jury. But once you are released, even if you have a conviction on your record, you can still serve on a jury. But in most states, a felony conviction of any kind can prohibit you from serving on a jury. And in a handful of states, like in places like Florida and Texas, a misdemeanor charge can actually prohibit you from serving on a jury as well. Now, this matters when it comes to equity within the criminal justice system, because when you look at who is systematically excluded from serving on these juries, it’s disproportionately black and brown people. So much so that, you know, when you look at the research, the latest estimates suggest that about one third of black men across the country nationwide have a felony conviction, which means that in most states you have a huge proportion of black men in particular, but black and brown people disproportionately overall who are prohibited from serving on juries, who who don’t have a voice on those juries that end up being the bodies that ultimately, you know, convict folks of crimes and lead to incarceration. So this is a huge issue in one county, actually, according to a 2011 study, over 60 percent of the black men in the county, in a county in Georgia were banned from serving on juries because of this policy. So, you know, as we continue to see progress being made on abolishing felony disenfranchisement, we saw the progress made with Amendment four. Even in California recently, they’ve expanded voting rights to folks who are on parole and probation. But this aspect of the system of exclusion for a criminal record is something that we just haven’t heard as much about and yet can play a huge role in the behavior of the criminal justice system. There is research showing that juries that are more racially diverse end up being leading to more productive outcomes, where people are more likely to engage with the facts, are more likely to have their own perspectives and biases challenged and addressed as they deliberate. And therefore, the outcomes of that deliberation can be less biased against black and brown people. So, again, this is something that that I hope we can see states, you know, really start to take action on through legislation. It varies by state. But overall, every single state has work to do. There are no states, according to this analysis, that do not ban people, any people from serving on the jury. It is limited in some places like Illinois and Colorado. But again, even there are folks who are incarcerated are prohibited. So there’s still work to be done.

DeRay Love the prison policy initiative. I didn’t know this, especially around the misdemeanor thing. And like all things, criminal justice and policing related. It’s just close to you who knew it was this close? So I’m looking at the chart you send and I’m like, OK, cool. I look at Maryland, it is all felonies and misdemeanors. Oh, right here I was like I had no I literally had no clue.

DeRay So that was sort of interesting. And then the sheer number of places, that’s all felonies and forever blew my mind, like Michigan, New Hampshire, New Jersey, Oklahoma, Pennsylvania. Like I just didn’t know this was like a forever thing in places. I thought there’d be like, you know, five years did it did it for a fixed period of time. And it was a no. And, you know, I do what they don’t engage in is sort of responding to the arguments of like, well, if you’ve done a crime, you shouldn’t be able to serve on a jury. Like, they sort of they just lay out the facts. But I do think there’s a lot of work to be done to help convince people outside of this the disparities that people who have faced a conviction should not be barred for life. I think that I think that the law and order culture that we’ve grown up in, especially TV, has convinced people that you have you’ve made it. You’ve done something that forever should bar, you from voting or from being on a jury like you sort of lost a right to participate in civic life. And and I do think that we need to, like, start making those cases more publicly. So my news is about kids and sexual predators. So there’s an article in The Washington Post titled “With Children Stuck at Home during coronavirus shutdowns, online sexual predators can swoop in.” And one of the things that they know is that during the first nine months of twenty twenty, the National Center for Missing and Exploited Children says it received 30000 reports of possible online enticement, which is defined as somebody communicating with a child online with the intent of engaging in a sexual conversation, obtaining sexually explicit images are meeting in person. Now, that puts them at a pace of about 40000 reports for the year, which is more than double the annual average of about sixteen thousand such reports over the previous four years. So the reason I bring this year is that there is this question of whether the pandemic has made it easier for sexual predators to target kids that there have been, you know, the article goes through some of these stings, one in New Jersey called Operation Screen Capture, where twenty one people were caught in response to an increase in reports of potential threats to children. The Fresno County Sheriff’s Office arrested 34 suspects. So like there are a host of these situations where it looks like kids are being targeted in a new way because everybody’s home, everybody’s on a computer instead of the narrative that they weave throughout. This is a story of a guy who I mean, this story blew my mind. He sort of grooms his 12 year old girl, picks her up at two thirty in the morning, has a put on a wig in the airport, and to act like she has a disability so she can’t talk and she goes to transfer her across state lines. So, like, wild in every possible way and so beyond wrong in a legal and gross and all those things. And I hadn’t even thought about, you know, what does it mean that there are so many more kids who are likely less supervised on the Internet just because they’re they’re sort of in zoom class all day or they’re on a computer all day in a way that just is very different than kids that probably normally been able to do. And what the consequence of that might be with regard to sexual predators and the number of homes where, you know, parents might have to still go to work, but the kid is at home on the computer, like, what does that look like? It does make me think, too, about all of the things we haven’t sort of considered that we will need to heal or deal with when kids come back to school and try to think through those things. So I brought it here because this is something I didn’t know about, something I hadn’t considered. You know, there are other people who say even in the article who are like, no, we don’t think there’s an increase. We think that it might be exacerbated a little bit, but but maybe not an increase. But I was convinced by the framing of the article that there is something to so many kids being at home and on the Internet and sexual predators taking advantage of that, especially in the article notes, especially the boredom factor, like people are probably having more chats and conversations just because they’re bored than before.

Kaya This made me really think about what these platforms might be able to do to help this, right? I mean, they can measure every keystroke they tell us. You know, they people know what our online behavior looks like. And it was it’s so kind of unsatisfying to hear platforms say they don’t have anything to do with this. And, you know, at some point, protecting young people just feels like something we should all be able to get our heads around together collectively to prevent.

Kaya The other thing that this made me think about was it’s not just sexual predators. I’m not sure if you saw this article about Dr. Laura Berman. She’s a relationship expert on TV and her 16 year old son died in the house with her, he connected with a drug dealer over Snapchat, the drug dealer sent him some fentanyl to the house. They had the drugs delivered to the house. He was experimenting. He wasn’t this wasn’t his thing. And he was 16 and he overdosed in the house. And the parents are there in the house with him. Right. And he hadn’t had contact with this person before. It was all kind of done online. And, you know, DeRay, you’re right. I’m sure he was bored. I’m sure he was in places that he wasn’t usually in and struck up conversations with people he didn’t. But even when you’re in the house with your kids, right. I mean, first of all, there are so many parents who are working or who may not be able to, you know, monitor their kids Internet activity or might not be in the house with them. But even sometimes when parents are, they have no idea what’s going on in this. You know, a woman lost her son.

Sam You know, it’s it is wild. And, you know, to drive to your point, this is I hadn’t even considered like this was happening. Right. I think there are so many things that as we have sort of collectively changed, like the way that we operate our lives, we were now doing much more digitally, much more virtually staying home much longer for many people. And I think that, like, there are so many other consequences to that shift that we still have yet to appreciate, have yet to understand, have yet to build defenses against, have yet to protect kids from. And, you know, it reminds me, you know, earlier on in the pandemic how we were talking about domestic violence and that, you know, reports of domestic violence were increasing in the initial months of the pandemic as more people were trapped inside with potential abusers. And now, you know, we’re seeing folks who are preying on children and again, exploiting the sort of new normal, it seems, of how we are interacting now virtually and distanced. So I think we’re just still at the tip of the iceberg of really understanding all of the different things that are sort of happening under the surface or happening beneath sort of the broader coronavirus narrative that are tied to it, but at the same time have their own sort of consequences for kids and families that have to be dealt with. And, you know, to your point, Kaya, like we we should be thinking about how are we protecting our kids and how are we making sure, like, these things can happen even if if your kid is in the house with you. Right. Like this is I’m not a parent yet, but, you know, I can imagine like, this is frightening to me. It has to be really frightening to parents. Right. So, like, how are we making sure that the way in which kids are accessing information is moderated to some degree? Right.

Sam Like I like you have to know if they’re having a conversation with, like a predator who is like apparently, according to this story, they had been talking for a while. Right. They had a whole plan. He was talking to multiple young kids all across the world. It wasn’t just in the U.S. There was people in Germany and all over it was wild. I didn’t even realize, like I didn’t even realize that, like, I guess I should have realized that they’re like people like that.

Sam But like that was also wild to read. But but again, I think, you know, we have to be telling these stories because these are real things that are happening right now. And parents may not even be aware that that their kid has been targeted or that their kid might be susceptible to something like this. And we should be aware and we should be doing what we can to stop it.

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DeRay And now I check in with Johnetta Elzie as she gives updates on what’s happening across the country with regard to the protests.

Netta Hey, what’s up, everybody? It’s me, Netta. Happy to be back with you this week.

Netta Two of my oldest friends, like I’ve known them since I was 17 or 18 years old. The venue was our spot back in the day back home. So Aaron and Tensy both happened to be nurses in Houston. And I’ve been talking to them everyday like normal, but this week had just such a different vibe to it.

Netta So I just have to publicly say that I am super proud of these two women for their service during this pandemic, for their spirit of perseverance. And I’m truly in all of them right now. So shout out to Aaron and Tensy and everyone who is doing their best in Texas to stay warm and safe all over the country as well. Now the news. A winter storm hit Portland last week, knocking out power for over 300000 homes and businesses.

Netta After hearing that there was a bunch of free and still pretty cold food tossed in the dumpster of a local grocery store by the name of Fred Meyer. Folks started showing up to evaluate what food was still edible in order to redistribute the food to those who need it.

Netta But that would be too much like. Right, right. So, of course, the police showed up to guard the dumpsters after store employees became scared by the people who came after seeing pictures of the treasure trove of food circulating on the Internet. According to local Portland activist, Juniper police threatened to arrest those trying to collect food for trespassing. And them, they them pronouns, for filming. The police. Guarding dumpsters with perfectly good food in it during a pandemic is just yet another answer to the age old chant. Who do you protect? Who do you serve?

Netta While the store management said that the food had to be thrown out because the store had lost power, folks on site said the food was still pretty cold and had not expired at all. Everything that I saw honestly online looks super fresh.

Netta Eventually, after the police left, people were able to collect food and distribute it through mutual aid networks. Goo old Lori Lightfoot is at it again, this time spending several bags on the police.

Netta Quoting The Chicago Tribune directly, “Mayor Lori Lightfoot’s administration spent two hundred eighty one point five million dollars in federal covid-19 relief money on Chicago Police Department personnel cost, prompting an angry response Wednesday from activists and even some aldermen.

Netta The number came to light as Litefoot seeks city council approval to transfer about 65 million in unspent federal dollars into the twenty twenty one budget after the Biden administration waived Federal Emergency Management Agency local funding matches and extended the deadline to spend federal dollars until the end of the year, a group of aldermen criticized Lightfoot’s administration for using those funds for police instead of putting them towards neighborhoods in desperate need for funding for housing assistance, schools, small businesses and other needs that prioritize people’s lives over the police department’s pockets.”

Netta And because I’ve been super interested in Mayor Lori’s response, I caught an update to the story on Tribune reporter Gregory Pratt’s Twitter timeline, and he said “Chicago Mayor Lori Lightfoot responds to critics who have ripped the city for spending two hundred eighty one million dollars and Kerrick’s actions on police payroll by saying, quote, ‘Criticism comes with the job of mayor.

Netta But this one is just dumb’ quote.”

Netta And my question is, is it dumb Mayor Lori or is it just called reading the room? Or how about listening to your constituents? I know that these are strange concepts. I know. I know. But you can do it. And the last story this week is about Seattle.

Netta The Seattle police shot and killed a man with a knife on the city’s waterfront last week. The man in distress was reportedly experiencing a mental health crisis as he held a knife to his own throat. According to the Seattle Police Department, a less than lethal tool was used against a man that was, quote, ineffective. Body cam footage shows the cops firing at them in less than 90 seconds after the recording starts. Please think about that. Even count. Thirty seconds out loud on your watch. Thirty seconds. That’s how long it took for these folks to show up to someone in a crisis.

Netta Well, OK.

Netta The Seattle Office of Police Accountability, as well as the Seattle Police Department’s force investigation team, are reviewing the shooting. This is the department’s second fatal shooting this month.

Netta There was a lot of news last week.

Netta And on Twitter, a lot of folks have been talking about just being burned out from the pandemic or burnt out from experiencing multiple first ever life changing events or experiencing both at the same time.

Netta And just to be clear. Oh, hey, it’s me. I’m folks, OK. The news is what it is, and the work is always going to be there. I say we keep doing what we can to maintain the peace We do have. Talk to ya’ll next week.

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DeRay Dr. Wachter, thanks so much for joining us today on Pod Save the People.

Dr. Bob Wachter My pleasure. Great to be here.

DeRay If you could fix the distribution, what would you do? And I ask because, you know, my my father is not he doesn’t even know how to, like, sit on the computer and click the refresh button. Right. You know, like that’s not he’s not doing that. So, like, what what is the structural fix?

Dr. Bob Wachter Yeah, I’ll tell you, my mother, who’s 85 and probably could give you your father a run for his money in terms of computer abilities, just got hers and our first one in Florida the other day, and she waited in the car for five hours. So I’d say that’s not it. You know, she got it. But that’s not optimal. It’s a tough problem. And we we clearly underestimated how tough a problem it was in the first months because we really blew it in the first few weeks of the rollout where you had vaccine sitting in freezers in every state in the country and 30 percent of it was being distributed, 70 percent of it was still sitting in refrigerators and freezers. So that wasn’t good. It’s gotten a lot better. It’s up to about 70 percent of the vaccine that’s out there in the states has been distributed. But it’s still, as you say, is still hard to figure out how to navigate. Every state has its own system. So you’ve got to figure out, is my state a state that’s using age only? And if so, what age? And are they using preexisting medical conditions? And what are they? And do I need a doctor’s note? And are they using my profession? And if so, how am I going to prove that I work in a meatpacking plant or a grocery store? It’s kind of a mess. And I think this was partly due to a failure, not the only one, obviously, of federal leadership under the last administration where they didn’t really weigh in on this. The CDC was politicized to the point of ineffectiveness. And so everybody had to kind of figure this out themselves. It’s got to be simple. It’s got to be straightforward. I personally have believed that the right call here was really focusing on age first. And many states are doing that where right now it’s everybody over 65. And what I would have done is a lottery. And the reason for that is that’s what they did at my institution, the University of California, San Francisco. And that’s what was done in the oil crisis in the in the 70s, where you could have made an argument for all sorts of different groups to have a priority in terms of their access to gasoline for their car. And at the end, we said, yeah, yeah, sounds right, sounds right. But it’s just too complicated. Let’s make it as simple as possible. So not sure how old you are, but I’m old enough to remember that if your license plate ended with an even number, you got it on an even day, ended up an odd number. You got an odd day and it worked out pretty well. So part of the challenge here is we were aiming for equity and in doing that and that’s of course, understandable and appropriate. But in doing that, in a lot of states, they created a lot of these sort of finally grained groups and made the system really complicated. And in my view, the more complicated it is, the less equitable it is. If you can look at the tax code, you know, the people that will be able to figure it out are younger or healthier, often have privilege.

Dr. Bob Wachter And and I think that’s what we’re seeing. When you look at the ratio of, you know, of who’s getting the vaccine, it tends to it’s about two to one right now in terms of whites versus blacks in terms of who has gotten the vaccine. And I think it’s because the systems are really complicated.

DeRay Is there a place doing this better than another place? Like is there a state that really is like a model for this, or is there a city that, like, really nailed it?

Dr. Bob Wachter So far, the the winner has been West Virginia and and probably because they took a lot of local control rather than a lot of the initial vaccinations, we’re going to be in nursing homes. And that was given by the federal government to big pharmacy companies, CVS and Walgreens to to work out which sort of sounds good on paper because they’re big and competent. But when it came to understanding how you’re going to get the folks in in rural nursing homes in West Virginia vaccinated was reduced. So that’s not going to work for us.

Dr. Bob Wachter We need to have the local health departments own this. And and they did. And they did it really well. So their percentage of people vaccinated in terms of the doses are being distributed essentially by population. So the bigger states get more. But the real question in the early days was how good are you at getting the vaccines out of your freezer into people’s arms? And the lesson of West Virginia was to really understand the local circumstances and the local needs. And these big national companies trying to do it often did not understand sort of the really particular issues of of every locality. But I have to say that this has all gotten better in the last two or three weeks at a national level. Three weeks ago, as I said, about 30 percent of the vaccines that were already FedEx had already dropped them off. And they were sitting in a freezer somewhere, let’s say, in California. And only one out of three doses had been injected, two out of three sitting in a freezer. They’re not doing anybody any good. That number nationally is up to about 70 percent now. And there’s some states at 80 or 90 percent. So I think that’s no longer the biggest obstacle, that it’s not the distribution. Now, we’re beginning to hit the bottleneck we thought we’d have all along, which is supply. We. I have enough and the racial disparities tell us that it’s not just how good are you at distributing the vaccine in your freezer, but how accessible have you made vaccination for people in different communities? And that’s everything from the websites and the, you know, people understanding where they get it and how they get it and all of that. But also thinking about neighborhoods like, you know, if you look at the maps of many cities and you look at the map by zip code of where are the greatest number of cases of covid and the greatest number of deaths and who has gotten vaccinated, they are mirror images of each other. So and it’s probably because it’s all part of the same it’s the same movie playing out twice. And so we have to figure out how to make those maps line up. If there are neighborhoods that are being hard hit by covid, you’ve got to have vaccination sites in those neighborhoods that people can easily schedule or walk up to and without having to wait five hours to get their vaccine. And I think we’re just beginning to attack that problem. But we neglected it for the first month.

DeRay Let me go back to these. The more vaccines are coming, because it blew my mind. Are they going to have the same problems with refrigeration? Are like are the new ones going to be ones that like don’t have to be kept in really cold places or they’re not going to like, expire? So we have the vaccine hunters or is that just like a consequence of vaccines?

Dr. Bob Wachter No, it’s actually one of the good things about probably the most exciting new vaccine that’s going to come online in about three weeks. It looks like it it’s going to go before the FDA in a couple of weeks and almost certainly get approved. It’s a vaccine made by Johnson and Johnson, and it has several advantages over Moderna and Pfizer. Those are the two that are out there today. The first is it can be kept in your regular old refrigerator. So Pfizer is the one that’s gotten all the news about the freezer. You know, it has to be on dry ice and and really, really have to be super careful about. And if the freezer fails, you got to figure out how to get it injected people in people in five hours. So this one is sort of like other vaccines that can be stored in the fridge, in a doctor’s office or in your local Walgreens or Publix or CVS. So that’s really good. That makes it easier, particularly as we think about rural communities. The second is it’s cheaper. That’s probably more important for the government than people right now because the government is buying it up and make it available for free. But that will be a big advantage, particularly as we think about vaccinations in developing countries. And the third, maybe the biggie is it is a single dose, whereas the as you know, the two that have been approved so far are two doses. The second one, three to four weeks after the first. So it has a lot of advantages, as in all things in covid, nothing comes of it comes easy. So the downside is in the studies so far, it is a little bit less effective in preventing symptomatic cases of covid. So whereas the Pfizer and Moderna vaccines, the ones that are out there today famously are 95 percent effective, meaning that a very, very small number of people will get a case of covid where they have symptoms at all and a positive test. The Johnson Johnson is if you add up all the numbers around maybe 70 percent effective, you might say, well, I want the good stuff. I want the ninety five percent. But the advantages of the Johnson and Johnson in terms of the refrigeration and the single dose, and the fact is it’s it’s a little bit less effective in preventing all cases of covid, but equally and breathtakingly effective in preventing severe cases and deaths. And that’s what we really care about. All three vaccines essentially are 100 percent effective in preventing you from getting sick enough to need to go to the hospital and have been 100 percent effective in preventing deaths. There is in the studies of of five different vaccines, including those three there were 75000 people that got vaccine. I think a grand total of two or three had to go to the hospital and a grand total of zero of them died. And that’s just staggering. I mean, these are incredibly good. So even though the top line number on the Johnson and Johnson is a little bit lower, if you told me, you know, if I could go to go to my Walgreens and get my Johnson Johnson vaccine today or I could wait a month because there might be more Pfizer or Moderna, I would be running to the pharmacy to get my Johnson Johnson vaccine.

DeRay A single dose.  I feel like you’re like blowing my mind. I don’t know where the articles are about the single dose coming, but I legitimately have missed them.

Dr. Bob Wachter This thing is so complicated and it’s been complicated all along. It’s just, you know, early on it was complicated as we talked about testing or we talked about masks or we talked about PPE. These days, the complications are trying to sort out the vaccines and trying to sort out the various. Even the two dose vaccines are a little bit more complicated than than meets the eye, because I and others have argued that the first dose of this of the two dose vaccines works awfully well. And there is an argument to be made to try to get as many people their first dose as quickly as possible. And if that means you have to put off the second dose for a few weeks, it’s still almost certainly going to work just as well and be safe and you get more people partly protected sooner. So there’s an ongoing debate about that one. There’s a new debate from a couple of papers that just came out in the last two days that are indicating that at least it looks like if you’ve had covid before, and that’s 25 million people in the United States know they had covid before, but probably 100 million people actually have because we didn’t test everybody. If you had covid before and you get your first dose of one of those two dose vaccines, the response you have in terms of the antibodies you develop are similar to someone who got the two doses if they never had covered before. In other words, it looks like your prior case of covid acts just like your first dose of vaccine and your then your first dose of vaccine acts like the booster for some never got it before. Now, if that turns out to be right, that’s a whole lot of people who may be able to be absolutely safe, just as safe as I am now with two doses, with a single dose. So you freed up tens of millions of doses. You freed up people from having to come back for a second one. And that’s you know, some people have side effects. So that would be a really terrific finding if that turns out to be true. Not quite ready for prime time, but the papers are pretty impressive and I have a feeling that’s going to turn out to be real.

DeRay What has the vaccine distribution exposed about the health care system like? I have to you know, for me as a lay person on the outside, it’s like who? I mean, forget the Trump administration’s just complete debacle.

Dr. Bob Wachter I’m trying, but go ahead.

DeRay It feels like this also is just like I think about giving everybody health care without also fixing the way that people make appointments. Which seems like so mundane, like does it matter? Like, you don’t really have access if you can never see the doctor, even if you have health insurance. So that’s something this moment made me think about. But what else should we be what else should this moment like prompt us to think about?

Dr. Bob Wachter Well, it’s a terrific question. It has exposed a whole lot of the dark underbelly of the health care system and but more importantly, the public health system. I think if you think about the health care system, if you have insurance and were able to get in to see a doctor and that obviously there are tens of millions of people who don’t or can’t. And so that’s a big problem. But if you could, I think the health care system stepped up and did pretty well. I mean, hospitals have done heroic work taking care of, you know, boatloads of sick people and improvising and turning the cafeteria into an ICU. And, you know, it’s been hellish and, you know, but I think at the end of the day, when we look back, we will say the health care system did what it could do given its structure and the limitations in terms of, you know, I mean, there’s only so much a doctor or nurse can do to take care of people. What it is really exposes a couple of things. One is our public health system has been massively underfunded and under supported forever. We spent about ten thousand dollars per person in the United States on health care and we spend about 50 or 60 dollars per person on the public health system. That’s the system that needs to respond to a pandemic or another public health emergency of the water supply, you name it, that. That’s it. That is a tremendous amount of under support of the public health system. And you might it’s sort of like a lot of things in prevention. You don’t realize you need it until you need it. And then when you say, well, why didn’t I invest in that? So it was ready. That’s what we’re learning here. And so everything from being ready with PPE, being ready with testing, being ready, with being able to communicate to different different communities about what they need to do to stay and keep themselves and their families safe. And now having a system to distribute vaccines to 300 million people, it just wasn’t ready for prime time. So we’re doing a lot of improv now. Again, without getting too much into the last administration, the public health system was made even worse than it should be because the CDC is a gem and is really one of the great public health agencies in the universe. And its job is to understand the data, organize all of this clear and consistent messaging about what we know and what we don’t know. And that didn’t happen under the last administration because it was politicized. We’re starting to see it happen now and it’s terrific, but. We’re going to have to build up the public health system, so we’re ready for the next threat, whether it’s a pandemic or something else, the information system is there. There is no information system in health care. Every you know, I got my two shots last month and they gave me a little piece of paper card and wrote on it, you know, that I got my shots. I mean, that’s a joke. It should be that there’s a national information system to track people and that they know what their health care needs are. You’re asking sort of what do we learn in the states about who did distribution right, that I should have generalized that the superstar here in the world is tiny Israel, which is managed to you know, we’re just hitting about 10 percent of our people vaccinated. Israel’s about 60 percent, six zero. And it’s because they were prepared. They’ve got a very good public health system. They have an information system that can track everybody in the country. They have a system we really don’t. We have this incredible patchwork and it doesn’t work very well on the average day. And it really doesn’t work when you need it and you need it during a pandemic.

DeRay I’m learning a lot. I want to ask you about the strain. So I have heard I’ve read stories about the new strains of covid and now that I’m, like, still fascinated by these new vaccines, will they, will  we get in front of the new strains, do somebody have to make like a whole new vaccine now? Because there are new strains like what’s what’s the what?

Dr. Bob Wachter Yeah. If this is actually genuine drama, when somebody does the you know, the the covid-19 movie, there’s going to be lots of twists and turns in the plot. We’re now at a point where the answer to your question is nobody knows. And it’s a race. And the race is, can we get enough people vaccinated in the next six to eight weeks so that we essentially are ready for what could be a tsunami from these these new strains. And here’s the here’s the math that that in in England, they found the first and they they check for strains and variants much more than we do. They have a very robust system of genetic sequencing of the virus. So in in November, they found on their radar screen this new mutation had popped up. Now, that’s not a big deal because this virus mutates all the time. And so, you know, for a year I was telling people, oh, yeah, there are mutations and they help us track viruses because they’re a little fingerprint’s. But no big deal doesn’t mean anything. No, no different. It’s still the same old virus. What happened in England starting in November was that became not true. They found this new strain and then what they found in December in London and mostly in southeast England was they were on a version of lockdown and they knew from the prior surges that normally, OK, we kind of lock things down and close the bars and close the restaurant. We should start seeing cases plateau and start coming down in a couple of weeks. And they looked and they two weeks went by and cases were continuing to go up and they said, you know, what the hell’s going on here? And they said, is there something different about this virus than the one that we’ve been battling for the last ten months? And the answer is yes. The answer is the virus had picked up a new superpower, and that is it is about 50 percent more contagious than the virus that they’ve been dealing with in the prior eight or nine months. And so the same kind of activity that they were had had done before that had turned the tide was no longer working. So in the course of two months, by the middle of January, that strain had become 70 percent of the cases in London. So from November, when they found the first first one of them, it had gone it had grown so fast that it was now the dominant strain in London and in southeast England. So that strain we it’s called B117. But most people call it by sort of call it the UK strain. That strain is now in the United States. It’s growing at a pace that’s similar to the way it grew in England. And the best predictions are about six weeks from now. It will be just as it happened in London. It will be the dominant strain that we’ll be dealing with. What that means is we have to be prepared for a virus that is more infectious than before. If we as a society are doing exactly the same stuff we were doing before to protect ourselves. And that stuff was good enough to lower the cases. As we’re seeing now, the cases are coming down pretty fast. That may not work anymore. We may have to do more. But the good news is and that’s that’s a lot of what I’ve just said is a bummer. The good news is we’re also vaccinating people and now we’re vaccinating people pretty quickly. So here’s the race. You know, by the middle to end of March, if we can have enough people vaccinated. That as this strain is more contagious, but it tries to jump from one person’s nose to the next person’s nose or mouth and that next person is vaccinated, it’s got no place to go. So by the end of March, we’ll never be at this thing called herd immunity where so many people are immune. The virus just dies out. But we can be in a place where there’s enough people who are immune that it will sort of negate the fact that the virus is a better virus than the one we’ve been fighting for the last year. I hope that makes sense. It gets pretty complicated. And if you ask me who wins that race, the answer is I do not know at this point. You could if you were a betting person, I think you’d have 50/50 odds on the variant, largely the UK variant and the vaccine’s winning the race. But it’s all the reason, all the more reason why we got to really, really pick up the pace in vaccination. I would say one more thing, which is you probably also heard about two other strains. One of them came out of South Africa, the other one came out of Brazil. They are scarier and they’re scarier because not only do they seem to be somewhat more transmissible like the UK virus, but they also have gained another set of mutations that make the vaccine work less well against them. Right now, they’re pretty minor players in the United States. There have been a few reported cases we’re watching very carefully. In the short term, I don’t think that’s going to be the bigger issue. The bigger issue is this UK strain. And the good news about the UK strain is a vaccine seemed to work pretty well against it. So if we can just win that race, get people vaccinated quickly to the point that there’s so many people vaccinated that that strain doesn’t have the ability to grow exponentially, then, you know, then we’re on a really good path to being out of this mess and being back to something resembling normal by the fall. If we lose that race and that that and that strain takes over, then we’re behind the eight ball. That strain gets bigger and bigger. And then we have to begin talking about rejiggering the vaccines and giving people extra doses to try to combat these new strains.

Dr. Bob Wachter That may be something we have to think about in the fall or winter anyway, but we really, really want to win this race because we do not want this strain causing another major surge.

DeRay I also asked Dr Wachter to speak to one of the new antibiotic treatments that’s out, which everybody recommended for my dad after I posted that he had covid and he still has Covid, he’s doing OK. And I realize that I had never heard of that, so I wanted him to talk about it. Here we go.

Dr. Bob Wachter Well, I’m sorry to hear that your dad got covid. I hope he’s doing OK. The issue of treatment of covid hasn’t gotten a whole lot of attention for the last several months. It’s really been overwhelmed by all of the discussion about vaccination. But it’s really important because people still get covid, they still get sick. We still have a couple thousand people a day dying of it. And so treatment is really important. There have only been a few treatments that have been shown to work to decrease the rates of death from covid and probably the most important treatment that we found that decreases the risk of needing to go to the hospital. If you have covid is a group of treatments called monoclonal antibodies. What monoclonal antibodies are are basically the kinds of antibodies. When we talk about vaccination, the idea is that your body reacts to a portion of the virus, a portion called the spike protein. That’s the kind of money bit of the virus that that burrows into your cells and causes infection. Your body is primed to react to that protein, the spike protein, by developing the ability to produce your own antibodies, which then attack the virus before it can take root and also lower the the chance you can have a really bad case of the infection. So that’s what a vaccination does. It causes your body to develop antibodies that attack the money part of the virus. Monoclonal antibodies, on the other hand, are a form of antibody that is injected into a person. And the reason that you you might need monoclonal antibodies or benefit from monoclonal antibodies is when you get infected. The body doesn’t have enough time to react to a vaccine, to develop antibodies. In fact, what’s happening if you’re getting really sick is your body has gotten infected with the virus. It’s trying to rev up its immune system to attack the virus, but it’s losing. And so the idea behind monoclonal antibodies is if we can inject into a person antibodies that go ahead and attack the virus, that can decrease the chance that the person is going to get really sick and need to go to the hospital and need to go to the ICU and and potentially die. So that was the idea. Monoclonal antibodies became famous when when our former president took them, you may remember him talking about the miracle cure that he received when he received a cocktail of antibodies, two different antibodies from a company called Regeneron. The two main companies that produce monoclonal antibodies are a company called Lily and another called Regeneron. And both have now been demonstrated to work pretty well in a very specific circumstance.Andn that circumstance is a patient who is has a diagnosis of covid within the first few days after the diagnosis. So let’s say you have a fever or a cough or you’re short of breath and you get a nasal swab and it shows that you have covid you’re not yet sick enough to go into the hospital, but you definitely have symptoms and you’re at high risk of a bad outcome. So maybe it’s because you’re an older person over 65 or you’re obese or you have preexisting lung or heart disease. The evidence is now quite clear that if you if you inject into that person these monoclonal antibodies, you will decrease the risk that they’ll get very sick and need to go into the hospital by about 70 percent. So that’s a pretty big deal. Why haven’t you heard more about them? They’re a little tricky to give. In the early days. We took an hour to administer them. You have to put in an I.V. and it took an hour to infuse them in through the IV and then you had to watch the person for an hour. Those times have gotten shortened a little bit, but it’s still a little tricky to do. Many hospitals only have a single place where they can give intravenous medicines to outpatients, and that is mostly a place where they do that for cancer patients. And of course, you wouldn’t want to put a covid patient, a person with active covid in the bed next to a cancer patient. So it’s taken a little bit of energy and effort for hospitals to figure out how to give monoclonal antibodies. We don’t do it probably as much as we should. They’re fairly expensive. But the evidence is pretty clear that for an older person or someone with significant risk factors to get sick from covid not a healthy young person with covid, but an older person, obese person, someone with preexisting medical illness who develops a case of covid and has symptoms, if you can give them these monoclonal antibodies in the first few days before they’re sick enough to go to the hospital, that seems to improve their outcomes. Funny enough, giving these antibodies after they’re really sick and in the hospital, it doesn’t seem to do very good. So vaccination is going to turn out to be the most important thing to try to decrease the chances of getting covid and the chances of of getting really sick, wearing your mask, keeping your distance if you’re if you’re not vaccinated is also really, really important. But there now are a few treatments and monoclonal antibodies is the most important one for a person who’s not yet sick enough to be in the hospital. If they can get that, that’s a good idea and it decreases the chance they’ll get super sick.

DeRay Well, that’s it. Thanks so much for tuning into Pod Save the People this week. Tell your friends to check it out, make sure that you rate it wherever you get your podcast whether it’s Apple podcasts or somewhere else.  ANd we’ll see you next week. To be was a production of Crooked Media. It’s produced by Brock Wilbur and mixed by Bill Lancz. Our executive producer Jessica Cordova, Kramer and myself special thanks to our weekly contributors Kaya Henderson, De’Ara Balenger, and Sam Sinyangwe, and our special contributor Johnetta Elzie.